McGlashan T H, Bardenstein K K
Chestnut Lodge Research Institute, Rockville, MD 20850.
Schizophr Bull. 1990;16(2):319-29. doi: 10.1093/schbul/16.2.319.
This study examines gender differences in the clinical profiles and long-term outcomes of chronic DSM-III Axis I psychotic inpatients from the Chestnut Lodge followup study. Diagnostic groups include schizophrenia, schizoaffective psychosis, and unipolar affective disorder. Sex differences were frequent, especially in schizophrenia. Females with schizophrenia, for example, had superior premorbid social, sexual, and marital adjustments. They presented at index hospitalization with more depression, self-destructive behaviors, and troubled interpersonal relationships. Their long-term outcomes were better than males in terms of social activity, work competence, time symptomatic, substance abuse, and marital and parental status. Baseline gender differences were comparatively sparse for the schizoaffective and unipolar cohorts. Outcome differences were virtually nonexistent among the schizoaffective patients but unipolar females received better ratings than males in work competence and substance abuse. Females had a later onset of illness and males presented with more antisocial behaviors across all three diagnostic groups. Results highlight the importance of analyzing data by gender in studies of the psychotic disorders.
本研究通过栗树屋随访研究，考察了慢性DSM-III轴I精神病住院患者临床特征及长期预后的性别差异。诊断组包括精神分裂症、分裂情感性精神病和单相情感障碍。性别差异很常见，尤其是在精神分裂症中。例如，患有精神分裂症的女性病前在社交、性和婚姻方面的适应能力更强。她们在首次住院时表现出更多的抑郁、自我毁灭行为和人际关系困扰。在社交活动、工作能力、症状持续时间、药物滥用以及婚姻和父母身份方面，她们的长期预后比男性更好。对于分裂情感性和单相情感障碍队列，基线性别差异相对较少。分裂情感性障碍患者之间几乎不存在预后差异，但单相情感障碍女性在工作能力和药物滥用方面的评分高于男性。在所有三个诊断组中，女性发病较晚，男性表现出更多的反社会行为。研究结果凸显了在精神病性障碍研究中按性别分析数据的重要性。
